Avastin as an adjunct to vitrectomy in the management  of severe proliferative diabetic retinopathy: a prospective  case series.
OBJECTIVE
Bevacizumab (Avastin) is a monoclonal antibody which targets all isoforms of vascular endothelial growth factor A. Its potent anti-angiogenic effects have been shown to cause regression of neovascularization in proliferative diabetic retinopathy. The aim of this study is to investigate the role of Avastin as an adjunct to vitrectomy in the management of severe diabetic eye disease.


METHODS
Sixteen patients (18 eyes) with severe proliferative diabetic retinopathy were recruited into the study. All eyes underwent a single intravitreal injection of bevacizumab 1.25 mg in 0.05 mL prior to vitrectomy surgery for the management of tractional retinal detachment or vitreous haemorrhage due to severe proliferative diabetic retinopathy.


RESULTS
At 3 months, seven eyes had visual acuities which were better than baseline, four were unchanged and seven were worse. At 6 months, 14 eyes had visual acuities better than baseline, one was unchanged and three were worse. Seven of the 18 eyes (38.8%) had postoperative rebleeds, six of which required surgical washout.


CONCLUSIONS
Avastin improved the ease of the surgery in these complex eyes and the early results are encouraging. We have found it to be particularly useful in diabetic eyes with traction detachments of short duration in which there is still active neovascularization.
Yeoh
Jonathan
J
Vitreoretinal Unit, The Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
Williams
Christopher
C
Allen
Penny
P
Buttery
Robert
R
Chiu
Daniel
D
Clark
Ben
B
Essex
Rohan
R
McCombe
Mark
M
Qureshi
Salmaan
S
Campbell
William G
WG
D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003930:Diabetic Retinopathy / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011300:Preoperative Care; D011446:Prospective Studies; D012163:Retinal Detachment / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D012720:Severity of Illness Index; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000188:drug therapy / Q000209:etiology / Q000601:surgery
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab